Epiglottoplasty in the treatment of laryngomalacia

Laryngomalacia is the most common congenital laryngeal anomaly. Usually the symptoms are mild, do not interfere with growth and development and resolve spontaneously. Occasionally it results in failure to thrive, apnea and cardiopulmonary disease. These children have traditionally experienced a stormy course, sometimes ending with tracheostomy. We present our experience with a recently described endoscopic procedure that involves the excision of redundant mucosa over the lateral edges of the epiglottis, aryepiglottic folds, arytenoids and corniculate cartilages. In six cases operated at the Montreal Children's Hospital there were no complications. Their pre-operative symptoms resolved after surgery. The cases, indications and complications reported in the literature are discussed. We conclude that in certain severe cases of laryngomalacia, epiglottoplasty is a useful and safe tool.